提升血液透析病人血磷控制成效之專案

Improving Control of Serum Phosphorus in Patients on Hemodialysis

楊春紀(Chun-Chi Yung) ； 黃雯嵐(Wen-Lan Huang) ； 黃瑞蘭(Jui-Lua Huang) ； 馬瑞菊(Jui-Chu Ma)

《馬偕護理雜誌》 3卷2期 (2009/07) Pp. 37-46

https://doi.org/10.29415/JMKN.200907_3(2).0004

摘要

花東地區血液透析人口族群分佈特殊，而本院透析室病人血磷值數據與腎臟醫學會評鑑要求之標準高出許多，透過結構式問卷查檢及統計分析後發現原因為：缺乏護理指導標準規範手冊、未制定「護理指導紀錄單」以監測護理人員執行情形、護理指導內容不符合現況及缺乏合適的語言溝通方法。經專案設計建立一、護理指導標準規範手冊，二、護理指導監測作業，三、護理指導相關的教材及工具及四、提供合適的語言溝通方法等。本室於2008年3月開始實施改善計畫，病患血磷值大於6.0mg/dl之長期透析病人由30.9%下降至17.9%，改善成效顯著，且達專案設定之目標值。未來仍將持續修正改善措施，以期提升護理人員的照護品質，增進洗腎病患日常生活滿意度。

關鍵字

血液透析 ； 血磷值 ； 成效

並列摘要

The serum phosphorus values in patients on hemodialysis in our hospital on the east coast of Taiwan were found to be much higher than the standard set by the Taiwan Society of Nephrology. An investigation of the reasons for this revealed deficiencies in nursing manuals, record-keeping, and communication and feedback. To address these problems, the following measures were taken: 1) publication of a Nursing Manual for the Hemodialysis Unit; 2) design of a clear record-keeping system to monitor compliance with standards; 3) revision of teaching materials; and 4) establishment of better communication. After implementation of the changes in March 2008, the percentage of patients on chronic hemodialysis whose serum phosphorus concentration exceeded 6.0 mg/dl was lowered from 30.9% to 17.9%. This result indicates the effectiveness of the scheme in reaching the target value.

並列關鍵字

hemodialysis ； serum phosphorus ； effectiveness